Burns and blisters
see also Burn wound (for soccorista). (merge these articles?) Burns There are 3 types of burns *Superficial burns (1st degree burns)-- affect the top layer of skin only. Skin is red and painful. *Partial-thickness burns (2nd degree burns)-- affect the top 2 layers of skin. Most notable by blisters (which may develop quickly or take 24 hours to form), but also red, mottled, wet and painful skin. *Full-thickness burns (3rd degree burn)-- all three layers of skin affected; leathery, dry, charred, gray. May not be painful because nerve endings have been destroyed OR may be very painful if surrounded by partial-thickness and superficial burns Making the burn safe *BSI (Body substance isolation) and Initial assessment. *Remove the source of the burn: **If there are flames, have the person stop, drop, and roll, or smother fire with a wool blanket. Keep them calm to avoid smoke inhalation injury. **Flush with water ::but be careful not to get soaking wet. Even in warm weather burns can produce hypothermia because of damage to the person's skin which regulates their body's heat. *Keep the person warm. Assessment *Decide how serious the burn is and if they need advanced care right away. Call emergency services: **If they inhaled smoke, were burned around the nose, mouth, or neck, or have trouble breathing. **If a blistering burn is on the hands, feet, face, any joint, or genitals. **If a blistering burn is large or goes all the way around a body part. **If they have a blistering burn and broken bones anywhere in their body. **If the burn is deep (3rd degree). **If there is a change in their mental status such as delerium, hallucinations, delusions etc. **If they develop a high or rising fever (over 101.5 in adults), or a red line from the burn area toward the center of the body. **If they appear dehydrated but cannot take oral fluids - remember that the smaller the person the easier fluid is to lose and the harder it is to replace. **If the burned person is younger than 5 or older than 55. First aid treatment Minor burns that do not form blisters (1st degree) To help ease the pain and lessen the damage caused by a minor burn, put the burned part in cold water at once. No other treatment is needed. They may take aspirin for pain. (confirm no allergy to aspirin) Burns that cause blisters (2nd degree) *Do not break blisters. Bad Idea. *Gently wash with soap and clean water. *You may apply nothing or aloe to the burn. Cover with a sterile non-stick (Telfa) gauze. If you are dressing fingers or toes, wrap them so they are separated. *Clean the wound and put on a new dressing every time it gets dirty or every day until the burn has healed. **If the dressing is stuck, you can soak it off with warm salt water (1 teaspoon salt to 1 liter water). If possible, add 2 tablespoons of bleach to the salt water. These soaks also clean the burn and prevent infection. *If the blisters are broken, treat the wound in the same way, only be even more careful to keep it clean and covered. *Never put grease, ointments, lotions, honey, antiseptics, or herbs other than aloe on a burn. It is very important to keep the burn as clean as possible. Cover it to protect it from dirt, dust, and flies. Deep burns (3rd degree) Deep burns that destroy the skin and expose raw or charred flesh are always serious, as are any burns that cover large areas of the body. Call 911 at once. In the meantime loosely wrap the burned part with a sterile dressing. Blisters Blisters are a symptom of 2nd degree and greater burns, but may also be caused by friction. Prevention (friction) *Shoes that fit or two pairs of socks. *Stop at the first sign of rubbing and apply athletic tape, medical tape, a solid piece of moleskin, or tincture of benzoin to any area that may cause problems. First aid treatment (friction blisters) *Cut a donut-shaped piece of moleskin and center the hole over the affected area to create a buffer. The doughnut part should be wide enough that when you put it on the tape doesn't stick to the blister (so it won't rip it off later!) *Do not break blisters open. *People with blisters can soak their feet in warm salt water (1 teaspoon salt to 1 litre water). If possible, add 2 tablespoons of bleach to the salt water. These soaks also clean the blister and prevent infection. Aftercare See Injury aftercare#Burn, Injury aftercare#Blister, or Injury aftercare#Taser injury for aftercare information. Infection If signs of infection appear-- pus, bad smell, fever, or swollen lymph nodes: *'Get the person to further care' (like a doctor). They may need antibiotics. Certain types of infections can kill a person within a few days. Special considerations #Taser #Special considerations for gunshot wounds and shrapnel wounds #Documenting injuries (police brutality) #Other protocols Notes En español: Primeros auxilios para quemaduras see also: * wikipedia:Wallace rule of nines This material is intended as a training supplement. Reading this material is no substitute for first aid / medical training with a qualified trainer. We encourage you to pursue ongoing education, reviewing and upgrading your skills-- for the safety of both yourself and anyone you treat. Category:Protocol